Patients on certain high risk or high cost medications may qualify them to receive individualized services from our Specialty Pharmacy. Patients enrolled in the these services can get assistance securing funding for their treatments, receive routine clinical follow-up from pharmacists as well as receive routine follow up communications from pharmacy technicians to assess their med adherence.

Resources

The following resources provide information on Willow Specialty Pharmacy functionality.

  • CoverMyMeds ePA Requests for Clinic Staff (CMM900) - (Video: 20 min) The process for clinic staff to generate ePA requests that are sent to the Central Pharmacy Prior Authorization team to manage. This process is only for clinics which are live with Pharmacy Central PA Management program.

  • Ordering Prescriptions for Pharmacists - (Handout) For specific workflows as defined by collaborative practice agreement (CPA), Pharmacists can place and sign prescription orders.

  • Pharmacy Prior Authorization Management - (Handout) For clinics and providers that are enabled, UIHC Pharmacy Staff will take ownership of completing all Prescription Prior Authorizations (PAs). As part of this implementation, some new tools will be implemented to help manage these Prior Authorizations (PA).

  • Specialty Pharmacy Enrollment Tip Sheet - (Handout) The process for assessing the services Specialty Pharmacy will provide is determined during the Enrollment process.

  • Pharmacy Interventions (i-Vents) for Pharmacists - (Handout) Pharmacy specific documentation that does not need to be visible in the patient’s chart, can be documented in Epic as a Pharmacy Intervention (i-Vent). Information in these i-Vents are used to track specific interventions that pharmacists provide and the time it takes to document those interventions.

  • Processing Prior Authorizations Requests from the In Basket - (Handout) For clinics and providers that are enabled, UIHC Pharmacy Staff will complete all their Prescription Prior Authorizations (PAs). Pharmacy Staff work these request/s from In Basket messages that are sent from the clinic.

  • Reviewing Estimated Patient Medication Adherence Levels - (Handout) Medication Adherence uses reported prescription fill information to assign a specific percentage value to estimate how compliant a patient has been with taking their prescribed medications.

  • Verify Pharmacy Benefits – Medical & Rx Benefit Crosswalk - (Handout) A patient’s pharmacy benefit plan (prescription coverage) is not necessarily the same as their medical insurance coverage. When more than one pharmacy benefit plan exists, a primary must be verified with the patient and selected.

  • Verifying Primary Prescription Coverage for Clinical Staff - (Handout) Many Pharmacy Benefit Managers (PBMs) currently send information to SureScripts about their subscribers (patients), including medications that are covered or may require prior authorization to be covered by insurance. For patients who are currently subscribers to PBMs which make this information available, their information is automatically pulled into Epic the night before the visit. This PBM information is also automatically updated when the patient is checked in and can be manually queried if needed.

  • Viewing Prescription Drug Monitoring Program (PDMP or PMP) - (Handout) Iowa’s Prescription Drug Monitoring Program (PDMP or PMP) can now be viewed by providers from Epic; providers and Pharmacists can access the PDMP from the patient Storyboard.

  • Viewing Real Time Prescription Benefits - (Handout) Clinical staff members, such as Nursing staff, Pharmacists, Licensed Independent Practitioners (LIPs) and Advanced Practice Providers (APPs) are able to view Real Time Prescription Benefits (RTPB).

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